This application is to develop a community-linked collaboration in the District of Columbia (DC) to plan a multi-site, multi-level study to investigate disparities in maternal and child health and, ultimately, to improve major outcomes among inner city, high risk African American women and their children. The leading partners are Georgetown University (including a new Center on Health and Education, the Center for the Study of Learning, and the National Center for Education in Maternal and Child Health), MedStar Health (the corporate entity that delivers many babies for high risk, low income African American women), and the D.C. Developing Families Center (a comprehensive, inner city family center that integrates a nurse-midwife model with an Early HeadStart program and case management services). [unreadable] [unreadable] The specific aims in Phase 1 are: (1) to develop a strong community-university collaboration to design and implement clinical research (Phase 2) to reduce health disparities; (2) to conduct exploratory studies to inform decision-making for Phase 2; (3) to provide interdisciplinary research training opportunities for minority scientists and clinicians; (4) to work with NICHD staff and other Phase 1 projects in planning; and (5) to advance the methods and theories related to the key clinical outcomes of fetal loss, low birthweight, prematurity, neonatal and infant mortality, and early childhood morbidity. [unreadable] [unreadable] The Georgetown-DC collaborative team offers expertise in prenatal care, parenting, child neglect and abuse, maternal depression, maternal substance abuse and smoking, early intervention for at-risk children, maternal intellectual disabilities, intergenerational poverty, early childhood care and education, family functioning, welfare reform, health services models for inner city families, maternal infectious diseases, developmental neuroscience, and neuroimaging of young children's brains. Two sample studies are proposed, along with new methodologies, to investigate how the complex interactions among genetic, biological, behavioral, and environmental variables influence key health outcomes. [unreadable] [unreadable]